Nathaniel Josef Jellinek, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

11514 Issued in RI

Practice address

1672 S County TRL
Suite 101
East Greenwich, RI 02818-5098

Phone

(404) 885-6647

Fax

(401) 885-6639

NPI assigned

Jul 13, 2006

Last updated

Apr 24, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA, RI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

University of Massachusetts Medical School, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Professionals IncGroup PAC ID 9234283953, 19 clinicians

Pioneer Valley Dermatology PCGroup PAC ID 0244201960, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology Professionals Inc.

  • Dermatology Physician
  • East Greenwich, RI
  • NPI 1902040835
  Medicare reassignment Care Compare group NPD
• Pioneer Valley Dermatology PC

  • Dermatology Physician
  • Amherst, MA
  • NPI 1114020211
  Medicare reassignment Care Compare group NPD
• Coastal Dermatology Inc

  • Dermatology Physician
  • Westport, MA
  • NPI 1760927610
  Medicare reassignment NPD
• PV Bay State LLC

  dba Pioneer Valley Dermatology PC

  • Dermatology Physician
  • Amherst, MA
  • NPI 1700698222
  NPD (past)
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1245256528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1672 S COUNTY TRL STE 101",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028185099",
            "telephone_number": "404-885-6647",
            "fax_number": "401-885-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 S COUNTY TRL",
            "address_2": "SUITE 101",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028185098",
            "telephone_number": "404-885-6647",
            "fax_number": "401-885-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 E Washington St",
            "address_purpose": "LOCATION",
            "city": "North Attleboro",
            "state": "MA",
            "postal_code": "027602312",
            "country_code": "US",
            "telephone_number": "508-699-7546",
            "fax_number": "508-699-7570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 Cottage St Ste B",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "MA",
            "postal_code": "010022178",
            "country_code": "US",
            "telephone_number": "413-549-7400",
            "fax_number": "413-549-7402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JELLINEK",
        "first_name": "NATHANIEL",
        "middle_name": "JOSEF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "220846",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MA",
            "license": "220846",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "RI",
            "license": "11514",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "11514",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NJ53855",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• International Languages LLC
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• Kaylee Janton
• Stephen C Jarrow, D.C.
• Mehran Javid, DMD
• Joanne C Lewis DDS LLC (West Bay Dental Group)
• Joanne C Lewis Pediatric Dentistry LLC (Chariho Children's Dentistry)
• John E Anzivino
• John G Slattery MD
• John J. Cribb, MD, Inc.

• MOHS-Micrographic Surgery Physician in East Greenwich, RI
• Providers in East Greenwich, RI by specialty
• MOHS-Micrographic Surgery Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.